Entropion is defined as an inward rotation of the eyelid margin. This condition results in the normally outwardly directed eyelashes and lid margin coming into direct contact with the surface of the eye. This eyelid malposition can lead to irritation and inflammation of the surface of the eye resulting in corneal ulceration and scarring.
While involutional or aging changes are the most common cause of entropion, there are a number of other conditions that can lead to this condition. It can be due to scarring of the conjunctiva from conditions such as Stevens-Johnson syndrome, herpes zoster, chemical burns and ocular cicatricial pemphigoid. It can also have a spastic etiology secondary to ocular irritation or blepharospasm. In some cases it can be congenital.
In involutional entropion, aging changes within the lower eyelid results in an imbalance of the supportive structures of the lid. The lower eyelid retractors, which are responsible for maintaining the lower eyelid margin in proper orientation, become attenuated. This leads to inward turning of the lashes and lid margin. Acute or spastic entropion occurs in elderly patients forcibly close their eyelids in response to chronic ocular irritation.
There are a number of treatments for entropion. In mild cases, antibiotic ointment and removal of the offending eyelashes can provide temporary relief. The involved eyelid can also be taped away from the globe. If the entropion is secondary to blepharospasm, may help reduce the entropion. In many cases the only definitive treatment is surgical. There are a number of surgical procedures used for the correction of entropion. They range from minor in office suture correction (Quickert procedure), to more extensive surgical correction that restores the eyelid to its normal anatomic position.